Provider Demographics
NPI:1659400315
Name:KASTEN, SUSAN KAY (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:KAY
Last Name:KASTEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38469 DEXTER RD
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:OR
Mailing Address - Zip Code:97431-9725
Mailing Address - Country:US
Mailing Address - Phone:541-937-3405
Mailing Address - Fax:541-937-3405
Practice Address - Street 1:38469 DEXTER RD
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:OR
Practice Address - Zip Code:97431-9725
Practice Address - Country:US
Practice Address - Phone:541-937-3405
Practice Address - Fax:541-937-3405
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health